2012 RPS
VERMONT AND NEW HAMPSHIRE
STATE CHAMPIONSHIPS

Presented by Fair Haven Fitness

DATE: MAY 5TH , 2012

FULL POWER, BENCH ONLY, DEADLIFT ONLY, IRONMAN

LOCATION: FAIR HAVEN FITNESS
8 MAIN ST. FAIR HAVEN , VT 05743
802-265-3470

DIRECTOR: JAMES MATTA capejam@hotmail.com 802-265-3470

ENTRIES : PER DIVISION PER LIFTER IS $85 Cross-over $35

ENTRY DEADLINE-APRIL 28TH, 2012
50 LIFTER LIMIT
-FIRST COME FIRST SERVE $25 LATE FEE IF AFTER DEADLINE

LIFTING STARTS AT 10AM ON SATURDAY
RULES AND REGULATIONS AT 8:30AM

WEIGH INS FRIDAY 8AM-8PM ALL DAY
OR SATURDAY FROM 7AM-8AM!

EVENTS: FULL POWER, BENCH ONLY, DEADLIFT ONLY, IRONMAN

DIVISIONS:MULTI-PLY,SINGLE PLY, RAW CLASSIC (NO KNEE WRAPS)
RAW MODERN (KNEE WRAPS ALLOWED)

CLASSES: Am (random drug test) Pro (non tested)
Elite Open, Police/Fire Pro and AM, Armed Forces,

AGE DIVISIONS: Open, Teen(14-15,16-17,18-19),Jun(20-23),submaster (33-39)
Master(per 5 yrs) Police/Fire, Armed Forces:Master 50+

WEIGHT CLASSES:MEN:114,123,132,148,165,181,198,220,242,275,308,SHW
WOMEN: 97, 105, 114, 123, 132, 148, 165, 181, 198, 220, SHW

RULES: All Lifters must be present for the rules clinic! All Revolution Powerlifting
Syndicate (RPS) rules apply. Equipment must be within (RPS) specifications. For
questions on rules Please feel free to visit the website www.RevolutionPowerlifting.com
One-piece lifting suit must be worn.

2012 RPS VERMONT AND NEW HAMPSHIRE
STATE CHAMPIONSHIPS Entry Form

IMPORTANT:
SPECTATOR/COACHES FEES $5 AT DOOR
ENTRY FEE PER LIFTER $85 INCLUDES MEET, T-SHIRT AND 1 5 X7 PICTURE
ADDITIONAL DIVISIONS -$35

T-SHIRT SIZE____ S,M, L, XL,2XL,3XL,4XL

EVENTS: FULL POWER___ | IRONMAN____ |
SQUAT ONLY___ | BENCH ONLY____ | DEADLIFT ONLY___

DIVISIONS: MULTIPLY___ | SINGLE PLY___ |
RAW CLASSIC(NO WRAPS)____ | RAW MODERN(WRAPS)___

CLASSES: AM(RANDOM TESTED)___ | PRO(NON TESTED)___
ELITE OPEN(PLEASE INCLUDE $100 MANDATORY TEST FEE!______
POLICE/FIRE AM___ | POLICE /FIRE PRO___ | ARMED FORCES AM___ | ARMED FORCES PRO___

AGE DIVSIONS: OPEN___ | SUBMASTER(33-39)___ | TEEN___ (age) | MASTER___ (age)| JUNIOR(20-23)___

WEIGHT CLASS____ | SEX M OR F

NAME________________________________ AGE____ BIRTH DATE________

ADDRESS____________________________________ CITY_________________ ZIP____________

STATE_____ PHONE___________________________ EMAIL_______________________________

PAYMENT CHOICE: CASH,CHECK, MONEY ORDER AMOUNT PAID______

ALL PAYMENTS CAN BE MADE OUT TO FAIR HAVEN FITNESS. THEY CAN BE SENT TO:
FAIR HAVEN FITNESS 8 MAIN ST. FAIR HAVEN,VT 05743
FOR QUESTIONS PLEAS CONTACT JAMIE AT (802)265-3470 OR capejam@hotmail.com

PAYMENTS DUE BY APRIL 28TH! OR ($25 LATE FEE WILL BE APPLIED)